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Sushruta SamhitaKarna gata Roga Pratisedha - Treatment of the diseases peculiar to the...

Karna gata Roga Pratisedha – Treatment of the diseases peculiar to the ear – Sushrutasamhita Uttaratantra Chapter 21

एकविंशोऽध्यायः अथातः कर्णगतरोगप्रतिषेधं व्याख्यास्यामः, धन्वन्तरिः ॥ १ ॥ यथोवाच भगवान्

Now we shall discourse on the chapter which treats of the medical treatment of the diseases peculiar to the ear (Karna-gata-Roga Pratisedha ). 1

General Treatment of diseases of the ear

सामान्यं कर्णरोगेषु घृतपानं रसायनम् । अव्यायामोऽशिरः स्नानं ब्रह्मचर्यमकत्थनम् ॥ २

General Treatment – Potions of clarified butter (after meal), use of Rasayana-measures,¹ renunciation of all sorts of physical exercise, baths without immersing the head, absolute sexual abstinence and abstinence from talkativeness are the general remedies and rules to be prescribed in the affections of the ear in general. 2

Treatment of the Vataja Ear-diseases

कर्णशूले प्रणादे च बाधिर्यक्ष्वेडयोरपि । चतुर्णामपि रोगाणां सामान्यं भेषजं विदुः ॥ ३ ॥

स्निग्धं वातहरैः स्वेदैर्नरं स्नेहविरेचितम् । नाडीस्वेदैरुपचरेत् पिण्डस्वेदैस्तथैव च ॥३॥

Treatment of the Vataja Ear-diseases — The course of medical treatment to be pursued in the four forms of the ear-diseases (all due to the action of Vayu) vis., Karna-sula, Pranada, Badhirya and Karnaksveda is the same and is as follows, Sneha should be first administered (both internally and externally) and the patient purged with emulsive purgatives after which the affected locality should be fomented with Vayu-subduing drugs administered in the manner of Nadi-sveda or Pinda-sveda. 3-4.

1. In place of “Rasayana” (use of tonic) some read “Rasasannm” (use of meat-soup with meal).

बिल्वैरण्डार्कवर्षाभू-दधित्थोन्मत्तशिग्रुभिः । बस्तगन्धाश्वगन्धाभ्यां तर्कारीयववेणुभिः ॥ ५ ॥ आरनालै शृतैरेभिनाडीस्वेदः प्रयोजितः । कफवातसमुत्थानं कर्णशूलं निरस्यति ॥ ६॥ मीनकुक्कुटलावानां मांसजैः पयसाऽपि वा । पिण्डै: स्वेदञ्च कुर्वीत कर्णशूलनिवारणम् ॥ ७॥

A case of Karna-sula (ear-ache), due to the concerted action of the deranged Vayu and Kapha of the locality yield to the application of fomentation to the affected part with (the fumes of) Bilva, Erandaroots, Arka, Varsabhu, Kapittha, Dhusturaka, Sigru, ajagandha, Asvagandha, Jayanti, Barley and bamboo, boiled in aranala (fermented rice-gruel) and administered in the manner of Nadi-sveda (Fomentation through a pipe ). An attack of Karna-sula (ear-ache) yields to the application of Pinda-sveda made with pieces of boiled flesh of fish, cock or Lava (jointly or seperately), or with (balls of condensed) milk. 5-7.

अश्वत्थपत्रखल्लं वा विधाय बहुपत्रकम् । तदङ्गारैः सुसम्पूर्ण यत् तैलं च्यवते तस्मात् निदध्याच्छ्रवणोपरि ॥ ८ ॥ खल्लादङ्गारतापितात् । तत् प्राप्तं श्रवणस्त्रोतः सद्यो गृह्णाति वेदनाम् ॥ ९ ॥ क्षौमगुग्गुल्वगुरुभिः सघृतैर्धूपयेच्च तम् । भक्तोपरि हितं सर्पिर्बस्तिकर्म च पूजितम् ॥ १० ॥

A bowl-shaped cup should be made of the leaves of the Asvattha soaked in oil and Dadhi-mastu¹ and it should be heated by means of charcoal-fire. The oil, thus heated and made to drop into the affected organ, gives instantaneous relief in case of ear-ache. The affected organ should be fumigated with the fumes of burning pieces of Ksauma (Linen cloth) as well as with clarified butter, Aguru and Guggulu mixed together. Draughts of clarified butter as well as the application of Sirobasti after meal are also found beneficial. 8-10.

1. “Mastu” (curd-cream) is mentioned neither by Vnda nor by Cakrapani. According to Videha’s recipe, clarified butter should be used in place of oil in cases of the aggravation of the Pitta.)

निरन्नो निशि तत् सर्पिः पीत्वोपरि पयः पिबेत् । मूर्धबस्तिषु नस्ये च मस्तिष्के परिषेचने । शतपाकं बलातैलं प्रशस्तञ्चापि भोजने ॥ ११ ॥ कण्टकारीमजाक्षीरे पक्त्वाक्षीरेण तेन च । विपचेत् कुक्कुटवसां कर्णयोस्तत् प्रपूरणम् ॥ १२ ॥

A rice diet should be foregone in the night, and draughts of clarified butter followed by potions of milk. The Sata-paka Bala-Tailal should also be prescribed as Siro-basti, errhine, as well as MastiskyaSirobasti and sprinkling. It may also be given internally. Goat’s milk first cooked with Kantakari (in the manner of Ksira-paka) and then with the fat (Vasa) of a cock is extremely efficacious (in cases of earache) if used as an ear-drop. 11-12.

तण्डुलीयकमूलानि फलमङ्कोलजं तथा । अहिंस्राकेन्दुकान्मूलं सरलं देवदारु च ॥ १३ ॥ लशुनं श्रृङ्गवेरञ्च तथा वंशावलेखनम् । कल्कैरेषां तथाऽम्लैश्च पचेत् स्नेहं चतुर्विधम् । वेदनायाः प्रशान्त्यर्थं हितं तत् कर्णपूरणम् ॥ १४ ॥

The four kinds of Sneha (oil, clarified-butter, lard and animal marrow) duly cooked together with the Kalka of Tanduliyaka, Amkota fruits, Ahimsra, Kenduka-root, Sarala, Deva-Daru, Lasuna (garlic), Sunthi and the scrapings of bamboo-skin and with the liquids of acid² taste (instead of water) should be used as an ear-drop in order to alleviate the aching pain there in. 13-14.

1. For “Bala- Taila” – See chapter XV, Chikitsa Sthana. 2. The liquid acids here are Dadhi, Takra, Sura, Cukra ( a kind of Kanjika) and the expressed juice of Matulunga.

लशुनार्द्रकशिग्रूणां मुरङ्ख्या मूलकस्य च । कदल्याः स्वरसः श्रेष्ठः कदुष्णः कर्णपूरणे ॥ १५ ॥ श्रृङ्गवेररसः क्षौद्रं सैन्धवं तैलमेव च । कटुष्णं कर्णयोर्देयमेतद् वा वेदनापहम् ॥ १६ ॥ वंशावलेखनायुक्ते मूत्रे चाजाविके भिषक् । सर्पि: पचेत् तेन कर्णं पूरयेत् कर्णशूलिनः ॥ १७॥

The expressed juice of Lasuna, Sigru, ardraka, Murangi, Mulaka and (branch of) Kadali jointly or seperately poured lukewarm into the cavity of the organ acts as an excellent ear-drop ( in case of acute earache). As an alternative, the expressed juice of Srnga-vera mixed with honey, Saindhava and oil should be used lukewarm as an eardrop to alleviate the pain therein. Clarified butter¹ duly cooked with the scrapings of bamboo-skin and the urine of a ewe and of of a shegoat 2 should also be used as an ear-drop in case of earache. 15-17.

Dipika Taila

महतः पञ्चमूलस्य काण्डमष्टादशाङ्गुलम् । क्षौमेणावेष्ट्य संसिच्य तैलेनादीपयेत् ततः ॥ १८ ॥ यत् तैलं च्यवते तेभ्यो धृतेभ्यो भाजनोपरि | ज्ञेयं तद् दीपिकातैलं सद्यो गृह्णाति वेदनाम् ॥ १९ ॥ कुर्यादेवं भद्रकाष्ठे कुष्ठे काष्ठे च सारले । मतिमान् दीपिकातैलं कर्णशूलनिर्बर्हणम् ॥ २० ॥

Dipika Taila — Pieces of the roots of the major Panca-mula measuring eighteen fingures in length should be covered (extending only to three fourths of the whole) with a piece of linen and then soaked in oil. The stick so formed, should then be lighted and the oil pouring in drops therefrom should be used lukewarm ( as an ear-drop). It instantaneously removes the pain, and is known as the Dipika-Taila. Different kinds of Dipika-Taila may be likewise prepared with pieces of Deva-daru, Kustha or Sarala wood, and used in the same manner in cases of ear-ache. 18-20.

1. Both Vmda and Cakrapani read “Taila” (oil) in place of “Sarpih” (clarified butter). But we have the authority of Videha (as quoted by Srikantha Datta in his commentary on Vrnda) in favour of clarified butter.

2. Clarified butter should first be cooked with the urine of a. e.we and then with that of a she-goat — Dulhana.

अर्काङ्कुरानम्लपिष्टांस्तैलाक्तान् लवणान्वितान् । सन्निदध्यात् स्नुहीकाण्डे कोरिते तच्छदावृते ॥ २१ ॥ पुटपाकक्रमस्विन्नान् पीडयेदारसागमात्। सुखोष्णं तद्रसं कर्णे दापयेच्छूलशान्तये ॥ २२ ॥

Tender sprouts of Arka plants pasted with Kanjika (Amla) should be mixed with oil and salt. The paste thus prepared should be placed inside the hollow made in a branch of Snuhi tree and wrapped up with the leaves of the same plant. It should then be scorched in fire in the manner of Puta-Paka. The juice should then be squeezed out of it and used lukewarm as an ear-drop to alleviate the pain inthe ear. 21-22.

Different kinds of Ear drops

कपित्थमातुलुङ्गाम्ल-शृङ्गवेररसैः शुभैः । सुखोष्णै: पूरयेत् कर्णं तच्छूलविनिवृत्तये ॥ २३ ॥ कर्णं कोष्णेन चुक्रेण पूरयेत् कर्णशूलिनः । समुद्रफेनचूर्णेन युक्त्या चाप्यवचूर्णयेत् ॥ २४ ॥ अष्टानामिह मूत्राणां मूत्रेणान्यतमेन वा । कोष्णेन पूरयेत् कर्णं कर्णशूलोपशान्तये ॥ २५ ॥ मूत्रेष्वम्लेषु वातघ्ने गणे च क्वथिते भिषक् । पचेच्चतुर्विधं स्नेहं पूरणं तच्च कर्णयोः ॥ २६ ॥

Different kinds of Ear-drops- The expressed juice of Kapittha, Matulunga and Ardraka mixed together and made lukewarm, or the lukewarm Cukra ( a kind of Kanjika) should be used as eardrops in a case of ear-ache. As an alternative, the affected ear should be judiciously dusted with powdered Samudraphena in such a case. As an alternative, the eight kinds of officinal urines or any one of them made lukewarm and used as an eardrop may prove efficacious in removing an ear-ache. Similarly, a case of an ear-ache yields to the curative virtue of an ear-drop, composed of the four officinal kinds of Sneha duly cooked with the different kinds of officinal urine and acids (wine, sour-gruel, etc. ) as well as with the Vayu-subduing drugs. 23-26.

General and Specific treatment of Pittaja Ear ache

एता एव क्रिया: कुर्यात् पित्तघ्घ्रैः पित्तसंयुते ॥ २७ ॥

काकोल्यादौ दशक्षीरं तिक्तञ्चात्र हितं हविः ॥ २८ ॥

क्षीरवृक्षप्रवालेषु मधुके चन्दने तथा । कल्कक्काथे परं पक्कं शर्करामधुकैः सरैः ॥ २९ ॥

General and Specific treatment of Pittaja Ear-ache- The above mentioned mode of treatment (ear-drops and fomentations, etc.) with the Pitta-subduing drugs should be followed in Pittaja Karnasula (ear-ache). The use of the medicated Ghrita duly cooked with milk weighing ten times as much and with the drugs of the Kakolyadi group, as well as the Ghrita¹ duly cooked with the drugs of the Tikta (bitter) group would be found beneficial in such cases. Clarified butter duly cooked with the tender sprouts of Ksira-vrksa (milk-exuding trees), as well as with Yasti-madhu and Candana wood, or that cooked with the decoction of Bimbi with (the kalka of) sugar, Yasti-madhu and the purgative drugs would also be found beneficial. 27-29.

Treatment of the Kaphaja Karna sula

इङ्गुदीसर्षपस्नेहौ सकफे पूरणे हितौ । तिक्तौषधानां यूषाश्च स्वेदाश्च कफनाशनाः ॥ ३० ॥ सुरसादौ कृतं तैलं पञ्चमूले महत्यपि ॥ ३१॥ मातुलुङ्गरसः शुक्तं लशुनार्द्रकयो रसः । एकैकः पूरणे पथ्यस्तैलं तेष्वथवा कृतम् ॥ ३२ ॥ तीक्ष्णा मूर्धविरेकाश्च कवलाश्चात्र पूजिताः ॥ ३३ ॥

Treatment of the Kaphaja Karna-sula– In cases of KaphajaKarna-sula mustard oil or Ingudi oil will be found beneficial if used as an ear-drop. Decoctions (Yusa) of the drugs of the bitter group, fomentation (Sveda) with Kapha-subduing drugs, as well as the oil cooked with the drugs of the Surasadi, or the major Panca-mula group would be found beneficial. The expressed juice of Matulunga, Lasuna and Ardraka, as well as Sukta, or the oil cooked with any of them should be used as ear-drops in such cases. The use of strong headpurgatives (errhines), or of gargles is, likewise, recommended in such cases. 30-33.

1. Dahana says that Jejjatacarya holds these two recipes as unauthoritative.

कर्णशूलविधिः कृत्स्त्र पित्तघ्नः शोणितावृते ॥ ३४ ॥

The medical treatment in a case of ear-ache due to the vitiated condition of the blood should be just the same as that in the case of a Pittaja Karna sula. 34.

शूलप्रणादबाधिर्य-क्ष्वेडानान्तु प्रकीर्तितम् । सामान्यतो विशेषेण बाधिर्ये पूरणं श्रृणु ॥ ३५ ॥

Thus we have given a general outline of the course of treatment and remedial measures to be adopted in the four kinds of ear-affectons, viz. Karna-sula (earache), Pra-nada, Badhirya and Karna-ksveda. Now we shall deal with the special recipes and preparations of ear-drops to be employed in cases of deafness (Badhirya) 35.

Treatment of deafness

गवां मूत्रेण बिल्वानि पिष्ट्वा तैलं विपाचयेत् । सजलञ्च सदुग्धञ्च बाधिर्ये कर्णपूरणम् ॥ ३६ ॥ सितामधुकबिम्बीभिः सिद्धं वाऽऽजे पयस्यपि । सिद्धं वा बिल्वनिःक्वाथे शीतीभूतं तदुद्धृतम् ॥ ३७॥ पुनः पचेद् दशक्षीरं सितामधुकचन्दनैः । बिल्वाम्बुगाढं तत् तैलं बाधिर्ये कर्णपूरणम् ॥ ३८ ॥ वक्ष्यते यः प्रतिश्याये विधिः स च हितो भवेत् ॥ ३९ ॥ वातव्याधिषु यश्चोक्तो विधिः स च हितो भवेत् ॥ ४० ॥

Treatment of deafness – The oil duly cooked with water, milk and Bilva pasted with cow’s urine (as kalka) should be used as an eardrop in cases of deafness. Oil should be first cooked with goat’s milk or the decoction of Bilva fruit with sugar and Yasti-madhu and Bilva fruit (as kalka). When cooled down ( it should be churned with the hand and) the Sneha (oily portion) should be separated. This oily part, after being stirred in the decoction of Bilva¹ should again be cooked with milk weighing ten times and with (the Kalka of) sugar, Yastimadhu and (red) sandal wood. It should then be thickened and used as an ear-drop in cases of deafness. Measures and remedies, which will be mentioned in connection with Pratisyaya’ (catarrh) or have been already described in the chapter on Vata-Vyadhi² Chikitsa may be as well employed with benefit in the present instances. 36-40.

1. In place of “Bilvambu-gadha” some read “Bimbi-gadha”, i.e., mixed with an abundant quantity of powdered Bimbi fruit. – Dalhana.

कर्णस्रावे पूतिकर्णे तथैव कृमिकर्णके । समानं कर्म कुर्वीत योगान् वैशेषिकानपि ॥ ४१ ॥ शिरोविरेचनञ्चैव धूपनं पूरणं तथा । प्रमार्जनं धावनञ्च वीक्ष्य वीक्ष्यावचारयेत् ॥ ४२ ॥ राजवृक्षादितोयेन सुरसादिगणेन कर्णप्रक्षालनं कार्य चूर्णैरेषाञ्च चूर्णं पञ्चकषायन्तु कपित्थरसयोजितम् । कर्णस्त्रावे प्रशंसन्ति पूरणं मधुना सह ॥ ४४ ॥ Treatment of Puti – Karna, Karnasrava and Krmi-karna – mode of treatment to be employed in cases of Karna-sravakarna and Krmi-karna is the same as above. Now hear (describing) the general mode of treatment to be employed in them, fumigating, filling up the cavity of the ear (as with an ear), cleansing and washing should be employed according to exigencies of each case. The affected ear should be washed with decoction of the drugs of the Raja-vrksadi or the Surasadi group with the powders of those drugs. In a case of Karna-Srava, of the affected organ should be filled in with the powders (lecoction) of the Panca-kasaya³ drugs mixed with honey.

सर्जत्वक्चूर्णसंयुक्तः कार्पासीफलजो रसः । योजितो मधुना वाऽपि कर्णस्त्रावे प्रशस्यते ॥ ४५ ॥ लाक्षासर्जरसैर्वापि चूर्णितैः कर्णपूरणम् ॥ ४६ ॥

1. Chap. XXIV, Uttara-Tantra.

2. Chapter V and VI, Chikitsa-Sthana.

3. According to some, “Panca-Kasaya” means the barks of aragvadha, Sirisa, Jambu, Sarja and of Asvamara (Palasa), but Dalana, on the authority of the authors of the Tika and the Panjika, (the two commentaries) refutes this and holds that “Pancakasaya” means the barks of Tinduka, Abhaya, Lodhra, Samanga and of amalaka enumerated below in this chapter.

सशैवलं महावृक्ष – जम्ब्वाम्रप्रसवायुतम् । कुलीरक्षौद्रमण्डूकी- सिद्धं तैलञ्च पूजितम् ॥ ४७ ॥ तिन्दुकान्यभया रोधं समङ्गाऽऽमलकं मधु । पूरणञ्चात्र पथ्यं स्यात् कपित्थरसयोजितम् ॥ ४८ ॥

The use of the powders of Sarja-bark mixed with honey and expressed juice of the Karpasi fruit is recommended in cases of KarnaSrava. A compound consisting of pulverised Laksa and Sarja-rasa (D.R. Rasanjana) should be used in filling up the cavity of the affected organ in the said disease. The oil duly cooked, with the tender sprouts of saivala, Maha-urksa, Jambu and of Amra as well as with KarkataSrngi honey and Manduki is highly efficacious in these cases. Powders of the barks of Tinduka, Abhaya, Rodhra, Samanga and of Amalaka mixed with honey¹ and the expressed juice of Kapittha, should be similarly used. 45-48.

रसमाम्रकपित्थानां मधूकधवशालजम् । पूरणार्थं प्रशंसन्ति तैलं वा तैर्विपाचितम् ॥ ४९ ॥ प्रियङ्गुमधुकाम्बष्ठा – धातकीशिलपर्णिभिः । मञ्जिष्ठालोध्रलाक्षाभिः कपित्थस्य रसेन वा । पचेत् तैलं तदात्रावमवगृह्णाति पूरणात् ॥ ५० ॥

The expressed juice of Amra, Kipittha, Madhuka flower, Dhava and of Sala duly cooked with oil is likswise recommended as eardrops in these cases, The oil cooked with Priyangu, Yasti- madhu, Ambalika, Dhataki, Sita-parni, Manjistha, Lodhra and Laksa (as kalka), and with the expressed juice of the sprouts of Kapittha as the liquid, if used as an ear-drop, arrests the secretion in a case of Karna-srava. 49-50.

घृष्टं रसाञ्जनं नार्याः क्षीरेण क्षौद्रसंयुतम् । प्रशस्यते चिरोत्थेऽपि सास्त्रावे पूतिकर्णके ॥ ५१

1. Srikantha Datta in his commentary on Vrnda quotes this couplet, but does not read ‘honey’ there. He reads ” तथा ” in place of “मधु” ।

निर्गुण्डीस्वरसस्तैलं सिन्धुर्धूमरजो गुडः । पूरण: पूतिकर्णस्य शमनो मधुसंयुतः ॥५२॥

Treatment of Puti Karna

Treatment of Puti-Karna – Rasanjana rubbed and dissolved in the breast-milk and mixed with honey proved highly efficacious even in chronic and long-standing cases of Puti-karna attended with fetid discharge. The use as ear-drops of the compound composed of oil, the expressed juice of Nirgundi and honey mixed together arrests an attack of Puti karna. 51-52.

Treatment of Krumi karna

कृमिकर्णकनाशार्थं कृमिघ्नं योजयेद् विधिम् | वार्ताकुधूमश्च हितः सार्षपस्नेह एव च ॥ ५३ ॥

कृमिघ्नं हरितालेन गवां मूत्रयुतेन च । गुग्गुलो: कर्णदौर्गन्ध्ये धूपनं श्रेष्ठमुच्यते । छर्दनं धूमपानञ्च कवलस्य च धारणम् ॥ ५४॥

Treatment of Krumi-karna- Vermi-fuges should be employed for the treatment of a case Krumi-karna Fumigation of the affected parts with the fumes of (dried) Vartaku, or (the pouring of) mustard oil (into the cavity of the affected organ) is also beneficial in such cases. Vidanga and Haritala (yellow orpiment) mixed with cow’s urine (and used as an ear-drop) as well as fumigating the affected organ with the fumes of (burnt) Guggulu tends to destory the fetor in the ear due to local parasites. Administration of emetics, smoke-inhalation and gargles are also beneficial in such cases. 53-54.

Treatment of Karna-Ksveda, Vidradhi

कर्णक्ष्वेडे हितं तैलं सार्षपञ्चैव पूरणम् । विद्रधौ चापि कुर्वीत विद्रध्युक्तं चिकित्सितम् ॥ ५५ ॥

प्रक्लेद्य धीमांस्तैलेन स्वेदेन प्रविलाय्य च । शोधयेत् कर्णविट्कन्तु भिषक् सम्यक्शलाकया ॥ ५६ ॥

1. Dalana explains this to mean fumigation of the affected organ, as well as the use of the same in the manner of smoking.

Use of mustard oil as an ear-drop is efficacious in cases of Karna-ksveda¹ An abscess (Vidradhi) in the ear should be treated as an ordinary abscess. The affected ear should be sufficiently fomented after being filled in with oil so as to soften the filthy deposit in the cavity of the ear, after which the filthy matter should be extracted with a probe or a director (Salaka). 55-56.

Treatment of Karna kandu and Karna pratinaha

नाडीस्वेदोऽथ वमनं धूमो मूर्धविरेचनम् । विधिश्च कफहृत् सर्वः कर्णकण्डूमपोहति ॥ ५७॥

अथ कर्णप्रतीनाहे स्नेहस्वेदौ प्रयोजयेत् । ततो विरिक्तशिरसः क्रियां प्राप्तां समाचरेत् ॥ ५८ ॥

Treatment of Karna-kandu and Karna-pratinaha — Fumigation of the parts with the help of a tube (Nadi-sveda), administration of emetics, smoke-inhalations, head-purging (errhines), as well as all kinds of Kapha-subduing measures should be resorted to in case of Karna-kandu. Application of Sneha and of Sveda and then of headpurgatives (errhines) should be made in cases of Karna-pratinaha, and the treatment thereafter should conform to the nature of the specific deranged Dosa of the body involved in the case. 57-58.

Treatment of Karna paka

कर्णपाकस्य भैषज्यं कुर्यात् पित्तविसर्पवत् ॥ ५९ ॥ कर्णच्छिद्रे वर्त्तमानं कीटं क्लेदमलादि वा ।

शृङ्गेणापहरेद्धीमानथवाऽपि शलाकया ॥ ६० ॥ शेषाणान्तु विकाराणां प्राक् चिकित्सितमीरितम् ॥ ६१ ॥

Treatment of Karna-paka, etc. – Remedies and remedial measures described in connection with Pittaja Visarpa² should be used with equal profit in a case of Karna-paka (inflammatory suppuration of the ear). Any filth or vermin, etc. lodged in the cavity of the ear should be removed with the help of a probe, or (by cutting it) with a horn. Cures for the remaining cases of affections in the ear have been described before (in the Chikitsa-sthana, Chapters XVIII, VI and XXIII). 59-61.

1. The use of oil is also recommended in cases of abscess in the ear. In cases of acute and painful Vataja Vidradhi sesamum oil should be used, whereas in cases of Kaphaja Vidradhi the use of mustard oil is recommended- Dalhana.

2. In place of ‘Pittaja-Visarpa’, both Vrnda and Cakradatta read Ksataja-Visarpa.

Thus ends the twenty-first chapter of the Uttara-Tantra in the Susruta Samhita which deals the treatment of the diseases peculiar to the ear.

इति सश्रुत संहितायामुत्तरतन्त्रे कर्णगतरोगप्रतिषेधनामैकविंशोऽध्यायः ॥ २१ ॥

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